Tendonitis

Why Do Diabetic Patients Get Tendon Problems?

Sugar molecules attach to collagen in a process that gradually stiffens tendon fibres. Consequently, tendons lose elasticity, tolerate less load and inflame more readily. The Achilles tendon and the posterior tibial tendon are affected most often.

Additionally, reduced blood supply slows repair, so an inflammation that would settle in weeks for someone else can persist for months.

Which Tendons Cause Foot Problems?

• Achilles tendon: pain at the back of the heel, and tightness that pushes pressure onto the forefoot
• Posterior tibial tendon: inner ankle pain, with arch collapse if it fails
• Peroneal tendons: outer ankle pain and instability
• Toe flexor tendons: contributing to claw toe deformity

Why Does Achilles Tightness Matter So Much?

Because it changes where you load your foot. A tight Achilles lifts the heel earlier during walking, driving pressure into the forefoot. That is a direct route to a forefoot ulcer, which is why we assess Achilles tightness in every patient with a recurring wound under the ball of the foot.

How Is Tendonitis Treated in Diabetes?

Activity modification, stretching and physiotherapy come first, alongside footwear changes and heel lifts where appropriate. Steroid injections are used with real caution here, since they raise blood sugar and increase rupture risk in already weakened tendons.

Where Achilles tightness is driving forefoot ulceration, lengthening the tendon surgically is considered through our tendon surgery service, which reliably reduces forefoot pressure.

What Does Treatment Cost and How Long Does It Take?

Conservative treatment involves consultation, physiotherapy sessions and footwear, all priced upfront. Recovery is slower than in non diabetic patients, typically three to six months for full settling, so patience genuinely forms part of the treatment.